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Home: 585-***-**** - Cell: 585-***-**** - acvfvt@r.postjobfree.com PROFESSIONAL SUMMARY

Outstanding, competent, and performance-driven professional, offering wide experience in various aspects of health insurance,payroll including employee relations benefits administration, regulatory compliance, and performance management. Recognized for implementing procedures that positively impact corporate profitability, employee satisfaction, and overall productivity. Known for keen attention to detail with adeptness in generating high-quality solutions that enhance efficiency of every accomplished task. Successful in developing core competence initiatives to drive organizational change and performance developments. Motivated self-starter and cooperative team player, with outstanding ability to comfortably converse with various individuals and groups; able to multitask in fast-paced environments. Articulate communicator and problem solver with big-picture vision, dynamic direction, and tenacity to make high-stake decisions through experience-backed judgment, strong work ethic, and irreproachable integrity. Proficient in using Microsoft Office Suite (Word, Excel, PowerPoint, and Outlook) HRIS,ADP system and other sales and organizational systems.

ADDITIONAL PROFICIENCIES- Advanced knowledge of insurance and self-funded healthcare products. Deep understanding of maintaining meaningful relationship with the clients and insurance companies. Strong knowledge of communicating insurance claims education to clients works with clients, COBRA participants and other business units to resolve escalated clients issue. S KILLS Client acquisition expert Proactive team player Results-oriented Personable Policy coverage expert Prospecting Analytical Driven Life and health insurance products

SKILLS

Policy coverage expert

Life and health insurance products

Property insurance

Client acquisition expert

Results-oriented

Proactive team player

Personable

Prospecting

Driven

WORK HISTORY

02/2016 to 05/2016Personal Line Client service Agent First Niagara Risk Management – Rochester, NY

Met with prospective customers and business owners in their homes, businesses and other settings.

Calculated quotes and educated potential clients on insurance options. Respond to inquiries from agency insured and prospects as well as company referrals. Obtained underwriting information to quote/rate risks for new and renewal business and complete applications.

worked with a variety of tools and applications such as comparative rates, carrier systems, and agency management systems.

Maintained a comprehensive understanding of vendors, products, trends, and strategy as it rlates to plan designs and contributions. Negotiated new and renewal production goals with business development manager. Calculated quotes and educated potential clients on insurance options. 11/2015 to 01/2016Member and Billing quality Specialist II BlueCross and BlueShield of Rochester – Rochester, NY Performed daily.Weekly and monthly samples audits in accordance with BCBSA guidelines, federal mandates, company and department policies. These audits includes group benefits, reviewing enrollment, billing, reconciliation and system transactions across applicable system and serving for accuracy and Timeliness.

Processed recommendations for workflow modifications, processing guidelines, system documentation and/ or training documentation. Effective verbal and written communication skill and analytical, problem- solving skills.

Performed quality auditing to ensure that open enrollment applications and large group benefits were accurately input into the health care information system by the open enrollment processors.

Audited of claims that are on standby before actual payment is settled for providers and facilities.

Identified and reported discrepancies to management for follow-up and correction action.

Discuss observed inconsistencies and errors with appropriate M&B management. Strong understanding of HIPAA compliance.

Remains current with relevant legislative and regulatory mandates to ensure activities are in compliance with these requirements, Also, aware off all local, regulatory, operational and national policy changes. Consistently demonstrates high standards of integrity by supporting the lifetime Healthcare Companies mission and value.

Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical, Dental, vision and life documentation. 10/2008 to 09/2015Payroll and Employee Benefits Specialist II PAYCHEX INSURANCE INC – Rochester, NY

Developed and maintains comprehensive knowledge of new and existing client account set ups, their corresponding systems and Health & Benefits processes to ensure resolution of escalated client issues.

Maintain expected level of availability and call quality as determined by the department.

Gathered and interprets data to solve complex issues relating to the Health & Benefit products and services, while maintaining positive and professional relationships with internal and external partners.

Reviewed processes and streamlines daily tasks to maintain efficiencies within the departments.

Initiated the writing of comprehensive and site-specific benefits guide to explain policy procedures and forms for accurate benefits administration, resulting in a cost savings through time efficiency in streamlined operations. Provided support to the benefits manager regarding 401(k) discrimination testing. Collaborated with insurance carriers and consultants on benefit policy content and language ensuring clarity and consistency.

Applied applicable corrections in the payroll system, Enterprise. Reviewed employee compensations to ensure the company match was not applied to ineligible compensations.

Maintained documents and records to ensure compliance with all applicable state and federal insurance regulation.

Provided necessary documentation to states and federal insurance agencies as well as our insurance partners to ensure compliance with internal and external policies. Accurate and timely payroll processing over 15,000 employees. Enforced child suppot garnishments orders.

Communcate to non-exempt employees regarding deadlines and submissions of timecard, veriify accuracy and enter Paychex flex pay expert for payment. Processed data entry of new hires ensuring all appropriate documentation approval is received.

Processed manual adjustments and checks for special pay, etc, process exercised stock options received from stock administrator, and adjustments, coordinate with various departments such as HR and benefits for accuracy of payroll processing and Payroll records,process check and wire requests as needed to Account payable verify and input PTO hours taken into Paychex flex, administer wage garnishments, Organize and distribute payroll checks and Vouchers, provide customer service and respond in a timely manner to employees payroll related issues and inquiries. Researched and respond to notices received from Federal and State taxing authorities. Responsible for the entry of all new hires, transfers, salary changes, promotions, demotions, terminations and status changes into the Paychex HR/P ayroll system. Organized and maintain all Payroll records, ensure Compliance to tax laws, Federal labor Standards Act and State Labor laws.

Determined payroll liabilities by comparing employee federal and state income and social security taxes to employer's social security, unemployment and workers' compensation payments.

Processed gross pay, state and federal tax withholding, social security, Medicare and other deductions for all employees.

01/2003 to 01/2007Group Employee Benefits Account Manager CENTENE NSURANCE SERVICES, INC – Tempe, AZ

Oversaw all aspects of securing competitive quotes from carriers for medical, dental, group life, and disability plans.

Assessed plans based on client\'s needs and provided recommendation to producer. Provided support to producer in creating sales presentation and preparing for employee enrollment meetings.

Assumed full responsibility for open enrollment benefit summaries and other applicable carrier information.

Rendered assistance to producer in facilitating employee and new hire orientation meetings.

Collaborated with carrier representative to ensure timely and accurate processing of client\'s benefit plan.

Conducted training to the Client HR Department on carrier administrator responsibilities to guarantee correct and precise eligibility information. Analyzed client\'s first billing statement for accuracy. Developed and maintained professional rapport with client while continuously providing excellent customer service, including resolving billing issues and employee claims problems.

Audited client\'s daily benefit administration procedures to ensure its compliance with COBRA, HIPAA and ERISA provisions.

Designed and implemented system to document client calls and maintain constant contact.

EDUCATION

Jan 2002 Bachelor of Science: Health Care Management and Human Resources Arizona State University - Tempe, AZ

Health Care Management and Human Resources

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